Active NPI
Clair Marcus Morud
- Internal Medicine Physician
- Ashland, WI
National Provider Identifier
1174699268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 29218-020
- Practice address
- 1615 Maple LN Ste 1
Ashland, WI 54806-3610 - Phone
- (715) 685-7500
- NPI assigned
- Nov 28, 2006
- Last updated
- May 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 29218-020 | WI | Primary |
Addresses
Primary practice location
1615 Maple LN Ste 1
Ashland, WI 54806-3610
Mailing address
1615 Maple LN Ste 1
Ashland, WI 54806-3610
Phone (715) 685-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31410100 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29218-020 | WI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bad River Band of Lake Superior Tribe of Chippewa Indains Wis | Current | Accepting new patients | |
| Bad River Band of Lake Superior Tribe of Chippewa Indians Wis | Current | Accepting new patients | |
| Bad River Band of Lake Superior Tribe of Chippewa Indians Wis. | Current | Accepting new patients | |
| The Duluth Clinic, LTD | Past | Accepting new patients |
Locations
53585 Nokomis Rd
Ashland, WI 54806
Phone (715) 682-7133
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Bad River AODA Behavioral Health
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Ashland, WI
- NPI 1366618506
-
- Federally Qualified Health Center (FQHC)
- Ashland, WI
- NPI 1699701375
-
dba Bad River Clinic Pharmacy
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Ashland, WI
- NPI 1780702829
-
dba Essentia Health Ashland Clinic
- Multi-Specialty Clinic/Center
- Ashland, WI
- NPI 1215974357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463961600000",
"number": "1174699268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1615 MAPLE LN STE 1",
"city": "ASHLAND",
"state": "WI",
"postal_code": "548063610",
"telephone_number": "715-685-7500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 MAPLE LN STE 1",
"city": "ASHLAND",
"state": "WI",
"postal_code": "548063610",
"telephone_number": "715-685-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORUD",
"first_name": "CLAIR",
"middle_name": "MARCUS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2016-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "29218-020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31410100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ashland, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.